Partnership Basics

Partnership work is all the work done following the initial Choice appointment and any Choice Plus. This includes all follow-up work whether at a Core or Specific level. Core Partnership is where the bulk of intervention work occurs and can be done by most clinicians who have extended clinical skills at threshold level alongside their specialist ones- see Chapter 6: Core and Specific Work. Assessment and reformulation continues throughout contact with the family, in the normal way.

Some families will need additional Specific Partnership work, alongside the Core work. An example could be individual psychodynamic psychotherapy in conjunction with Core family work, or additional Specific assessment e.g. psychometry or ASD assessment.

Partnership work can be as many or as few sessions as are needed, as long as this is regularly reviewed against clear goals. We know that most families seem to receive an average of 7 Core Partnership. But the range may be wide! They are not limited to 7!

The Choice process ended with a Choice Point (the joint understanding of the problem and a decision as to future actions). So the aim of Core Partnership work is to:

Revisit the goals developed in the Choice Point. Have these changed?
Look at how the Pre-Partnership work went - what happened, what worked?
Use the Core threshold level skills that were identified in Choice as useful to the desired change
Explore important areas that may now arise. This may include gathering more information, finding out about other areas of their lives with the aim of strengthening the shared formulation with the family
Build on engagement
Build on the family’s hope for change
Continued consideration of risk, including safeguarding
Engage other agencies as needed and link with those already involved
Continue to provide written information about mental health issues and solutions and other sources of help, such as other agencies and websites
Let them go promptly!

The first Partnership appointment should not be just a repeat of the Choice appointment. That would be a waste of time for the family and the clinician. If the Partnership clinician is not the same person that saw them in Choice then the challenge for the clinician is to be continually aware that this is the first contact for them, but the second (or third) for the family. We’ve heard it described as like getting on a moving bus. This means that the Partnership clinician needs to read and reflect on the information gathered in Choice and continue to be very curious as to how the family and young person view things.

This means that the Choice components (Curiosity; Honest Opinion; Joint formulation, Discussion of alternatives, Choice and Consent and Engagement) is in all Partnership work. We continue to use our expertise to facilitate.

A range of Choices continue to be available throughout Partnership…

Choice as in:

To engage or not in the service
Whether to change or not
Who in the family comes
Venue (if you have several sites)
The formulation e.g. to label/medicalise the problem or not and
Goals
The type of interventions
Booking preferences for times and days
Subsequent appointments.

When someone is re-referred to the service they always have an initial Choice appointment before moving into Partnership, even if recently discharged. All families need a review of current issues and discussion of what they want.